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Logo of bmjThis ArticleThe BMJ
 
BMJ. 2007 November 3; 335(7626): 939.
PMCID: PMC2048835
Review of the Week

Life through a lens

Reviewed by Amy Davis, editorial registrar, BMJ

Eight UK doctors have been followed by a camera crew for the past 20 years. Has anyone's life gone to plan? Amy Davis watches the latest documentary series

Back in 1984 a BBC camera crew filmed eight medical students from St Mary's Hospital Medical School, as it was then called, in west London. In several programmes broadcast during the 1980s and three separate series screened in 1992, 1998, and 2002, viewers saw the student doctors progress through medical school to their final examinations and on to the early years of their medical career. This latest series of eight documentaries catches up with the same doctors 20 years since they were first filmed.

Today Nick Hollings is a consultant radiologist in Truro, Cornwall. In footage from 20 years ago we see Nick as a student being interviewed about working with patients. He says, “I'm not the kind of person that gets latched onto things emotionally too tightly, when they're not for my own personal gain—which sounds dreadful but you've got to be slightly callous in a way and cut yourself off before you get hurt, otherwise you can't carry on working.” In a 1991 interview Nick, this time working as a junior doctor, is feeling disillusioned by 52 hour shifts and bed shortages. “Am I actually living or am I just a machine?” he wonders. “It's just bloody misery, this is. Be better off as a dustman.”

But, 20 years on, was the hard work worth it? Once you became a consultant you had “made it,” so to speak, and you had a job for life. Or had you? The outsourcing of radiological scanning to the private sector in an attempt to reduce waiting lists and achieve government targets has left Nick unsure of his future.

“Times are very uncertain in the health service at the moment, and we're certainly feeling that in radiology we're staring down the barrel of a gun.” Nick is so concerned for the safety of his consultant job that he has a back-up plan “to keep the wolf from the door”: he is learning web design.

Back in 1984 Jane Gilbert's ambition was to become a consultant in obstetrics and gynaecology, but her career hasn't turned out as expected. Although described by the programme as “one of the brightest medical students” from her intake at St Mary's, Jane (whose programme, one of the last in the series, will be aired on 29 November) has left the NHS after working as a general practitioner and now works as an agony aunt for a teen magazine and also works in child health promotion. Ten years after breaking from work to have her first child, Gilbert shows no sign of returning to medicine. Back in 1997 she spoke of how the job left her emotionally exhausted: “It gets to the stage where I get six or seven people who've got emotional problems, and some evening surgeries I just feel completely drained.”

Gilbert now works from home, where we see her replying to an email from a 16 year old girl: “If your boyfriend is too immature to cope with the squelches and sounds of sexual contact and too insensitive to be kind and gentle with you, maybe you should look for someone better,” she writes. Of her lost medical career she says, “There is a price to pay when you train in medicine. It is a job that becomes your life. For me that was a price too high to pay.”

Modernising Medical Careers, although not mentioned by name, doesn't escape a bashing by Fey Probst, who is now an accident and emergency consultant. She talks of the problems created by speeding up doctors' training, combined with the reduction in hours brought about by the European Working Time Directive. “The fact that consultants will have had, let's say, six years of training at 48 hours a week, rather than 12 years of training at 100 hours a week, means they won't have the experience,” she says.

Among all the doom and gloom is Mark George, whose life turned out exactly how he wanted it to. From the age of 9 he wanted to be a surgeon, and he is currently one of the UK's leading colorectal surgeons, with a thriving private practice. “Being a consultant is probably how I thought it would be,” he says. “You're responsible for the patients who come to see you. You make decisions and hope you get them right. It's fantastic.”

With all the change in the NHS at the moment, the new doctors' hours, and Modernising Medical Careers I wonder what today's cohort of newly qualified doctors will be doing 20 years from now. Nick Hollings is gloomy: “The NHS is now being run as a business and not as a healthcare organisation.” He also warns junior doctors to take a look at the NHS now and think what it will be like in five years' time before choosing a specialty. Wise words.

Notes

Doctors to Be: Twenty Years On

BBC4, 7 30 pm, every Thursday until 6 December (repeated Fridays at 10 pm)

Rating: ***


Articles from The BMJ are provided here courtesy of BMJ Publishing Group